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Developing a scale to measure family dynamics related to long-term care, and testing that scale in a multicenter cross-sectional study.

Kusaba T, Sato K, Matsui Y, Matsuda S, Ando T, Sakushima K, Wakita T, Fukuma S, Fukuhara S - BMC Fam Pract (2014)

Bottom Line: The results were analyzed by factor analysis.The results of factor analysis indicated that the scale was unidimensional.The scale's scores are reliable and the results of validation testing were generally good.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute for Health Outcomes and Process Evaluation Research, Akinonocho, Nakagyo Ward, Kyoto, Japan. fukuhara.shunichi.6m@kyoto-u.ac.jp.

ABSTRACT

Background: As Japan's population ages, more frail elderly people are cared for by members of their family. The dynamics within such families are difficult to study, in part because they are difficult to quantify. We developed a scale for assessing family dynamics related to long-term care. Here we report on the development of that scale, and we present the results of reliability testing and validation testing.

Methods: Two primary-care specialists drafted questions about family dynamics, and discussed them with other primary-care physicians and clinical researchers. The final questionnaire asked about four problems or undesirable situations: disengagement (emotional distance), scapegoating (inappropriate blame), transfer of problems across generations (transfer of unnecessary burden from older to younger generations, trans-generationally displaced revenge), and undesirable behavior (co-dependence). Next, at six general-medicine clinics, doctors evaluated families that had a caregiver and a patient requiring long-term care. The results were analyzed by factor analysis. Cronbach's α was computed, and criterion-related validation tests were done with three types of criteria: relationship before caregiving, ability to do activities of daily living (ADL), and the duration of care.

Results: Results were obtained from 199 families. Among the caregivers, 79% were women and their mean age was 63 years. Among the patients, 71% were women and their mean age was 84 years. The results of factor analysis indicated that the scale was unidimensional. Cronbach's α was 0.73. Not having a good relationship before caregiving was associated with significantly worse family dynamics scores, as was greater dependence regarding ADL.

Conclusions: We developed a scale that enables physicians to assess the dynamics of families with a patient and a family caregiver. The scale's scores are reliable and the results of validation testing were generally good. This scale holds promise as a tool both for research and for primary-care practice.

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Association of relationship before caregiving with IF-Long scores. *Cuzick’s test for trends.
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Figure 2: Association of relationship before caregiving with IF-Long scores. *Cuzick’s test for trends.

Mentions: With the response to the question “How was your relationship with the patient before you began caregiving?” as the independent variable and the IF-Long score as the dependent variable (Figure 2), one-way ANOVA showed a main effect of the relationship before caregiving (F3,192 = 4.148, p < 0.01, Eta squared = 0.061). The Cuzick trend test revealed that not having a good relationship before caregiving was associated with higher IF-Long scores (Figure 2).


Developing a scale to measure family dynamics related to long-term care, and testing that scale in a multicenter cross-sectional study.

Kusaba T, Sato K, Matsui Y, Matsuda S, Ando T, Sakushima K, Wakita T, Fukuma S, Fukuhara S - BMC Fam Pract (2014)

Association of relationship before caregiving with IF-Long scores. *Cuzick’s test for trends.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109784&req=5

Figure 2: Association of relationship before caregiving with IF-Long scores. *Cuzick’s test for trends.
Mentions: With the response to the question “How was your relationship with the patient before you began caregiving?” as the independent variable and the IF-Long score as the dependent variable (Figure 2), one-way ANOVA showed a main effect of the relationship before caregiving (F3,192 = 4.148, p < 0.01, Eta squared = 0.061). The Cuzick trend test revealed that not having a good relationship before caregiving was associated with higher IF-Long scores (Figure 2).

Bottom Line: The results were analyzed by factor analysis.The results of factor analysis indicated that the scale was unidimensional.The scale's scores are reliable and the results of validation testing were generally good.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute for Health Outcomes and Process Evaluation Research, Akinonocho, Nakagyo Ward, Kyoto, Japan. fukuhara.shunichi.6m@kyoto-u.ac.jp.

ABSTRACT

Background: As Japan's population ages, more frail elderly people are cared for by members of their family. The dynamics within such families are difficult to study, in part because they are difficult to quantify. We developed a scale for assessing family dynamics related to long-term care. Here we report on the development of that scale, and we present the results of reliability testing and validation testing.

Methods: Two primary-care specialists drafted questions about family dynamics, and discussed them with other primary-care physicians and clinical researchers. The final questionnaire asked about four problems or undesirable situations: disengagement (emotional distance), scapegoating (inappropriate blame), transfer of problems across generations (transfer of unnecessary burden from older to younger generations, trans-generationally displaced revenge), and undesirable behavior (co-dependence). Next, at six general-medicine clinics, doctors evaluated families that had a caregiver and a patient requiring long-term care. The results were analyzed by factor analysis. Cronbach's α was computed, and criterion-related validation tests were done with three types of criteria: relationship before caregiving, ability to do activities of daily living (ADL), and the duration of care.

Results: Results were obtained from 199 families. Among the caregivers, 79% were women and their mean age was 63 years. Among the patients, 71% were women and their mean age was 84 years. The results of factor analysis indicated that the scale was unidimensional. Cronbach's α was 0.73. Not having a good relationship before caregiving was associated with significantly worse family dynamics scores, as was greater dependence regarding ADL.

Conclusions: We developed a scale that enables physicians to assess the dynamics of families with a patient and a family caregiver. The scale's scores are reliable and the results of validation testing were generally good. This scale holds promise as a tool both for research and for primary-care practice.

Show MeSH
Related in: MedlinePlus